ADVANCED DERMATOLOGY OF VIRGINIA INC – Dermatology Physician, NPI 1801342639
Dermatology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for ADVANCED DERMATOLOGY OF VIRGINIA INC
151 Southpoint, 151, Southhall Lane, Maitland, Orange County, Florida, 32810, United States
SUITE 300
MAITLAND, FL 327517176
Phone: (407) 875-2080
Fax: (407) 650-3455
Type: Location
45155 Research Pl Ste 140
Ashburn, VA 201474193
Phone: (703) 858-0500
Type: Location
419 Holiday Ct Ste 10
Warrenton, VA 201864372
Phone: (540) 878-5781
Type: Location
3700 Joseph Siewick Dr Ste 302
Fairfax, VA 220331739
Phone: (703) 648-2488
Type: Location
151 Southhall Ln
Suite 300
Maitland, FL 327517176
Phone: (407) 875-2080
Fax: (407) 650-3455
Type: Location
4660 KENMORE AVE STE 1100
ALEXANDRIA, VA 223041311
Phone: (703) 370-0073
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-04-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20161114000246 | O | Clinic/Group Practice | DC | TBD |
| O20220422000470 | O | Clinic/Group Practice | VA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32751)
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